• Utilization Review RN…

    Actalent (Atlanta, GA)
    Job Title: Utilization Review - FULLY REMOTE ...Benefits - Appeals, and Risk Management. Essential Skills + Registered Nurse ( RN ) with a valid ... + Experience with MCG or Interqual is preferred. + Utilization review experience is a plus. Work...or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to… more
    Actalent (11/14/25)
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  • Clinical Registered Nurse…

    Cognizant (Atlanta, GA)
    …to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with managed ... **Location:** Remote **About the role** As a Registered Nurse you will make an impact...as well as timely filing deadlines and processes. . Review clinical denials including but not limited to referral,… more
    Cognizant (11/15/25)
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  • SNF Utilization Management RN…

    Humana (Atlanta, GA)
    …an impact** **Use your skills to make an impact** **Required Qualifications** + **​Licensed Registered Nurse ( RN )** in the (appropriate state) with no ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing...in an acute care setting + Previous experience in utilization management/ utilization review for a… more
    Humana (09/12/25)
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  • RN UM Care Review Clinician…

    Molina Healthcare (Atlanta, GA)
    …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support...Friday 8:00am- 5:pm with rotational weekend and holiday coverage Remote position MA RN licensure required **Essential… more
    Molina Healthcare (11/13/25)
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  • RN Care Review Clinician…

    Molina Healthcare (Atlanta, GA)
    …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The Care Review Clinician ( RN ) provides support for...Further details to be discussed during our interview process. Remote - requires RN license Work schedule: Saturday… more
    Molina Healthcare (11/13/25)
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  • Utilization Review Clinician…

    Centene Corporation (Atlanta, GA)
    …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... are seeking a Licensed Clinical Behavioral Health Professional or RN to join our team! The ideal candidate will...abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with… more
    Centene Corporation (11/12/25)
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  • RN UM Clinical Appeals Nurse…

    Molina Healthcare (Atlanta, GA)
    …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal...the specific programs supported by the plan such as utilization review , medical claims review ,… more
    Molina Healthcare (11/14/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (Atlanta, GA)
    For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state they reside This role will be doing Utilization review ... 8 AM to 5 PM EST This is a Remote position, home office with internet connectivity of high...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/13/25)
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  • Medical Review Nurse ( RN )

    Molina Healthcare (Atlanta, GA)
    … and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must be active and unrestricted ... (Team will work on set schedule) Looking for a RN with experience with appeals, claims review ,...clinical nursing experience, including at least 1 year of utilization review , medical claims review ,… more
    Molina Healthcare (09/06/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (Atlanta, GA)
    For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet ... (Team will work on set schedule) Looking for a RN with experience with appeals, claims review ,...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/01/25)
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